| NPI | 1558336529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE T PULLEN Authorized Official 734-761-2629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017202) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-08-22 |